Matenda a shuga ndi matenda amkati: zovuta ndi chithandizo

Matenda a shuga akuchulukirachulukira, omwe amatchedwa mliri wapadziko lonse lapansi. Mwa odwala onse, 90% ndi mtundu wachiwiri wa matenda ashuga, omwe amayambitsa kunenepa kwambiri, zolimbitsa thupi komanso mawonekedwe amtundu.

Zomwezi zimathandizira kukulitsa matenda a mtima, impso, kapamba. Kupezeka kwa matenda amodzimodzi mu matenda a shuga kumadetsa nkhawa kwa odwala.

Matenda a shuga amachepetsa kubwezeretsanso njira zina mthupi, chitetezo cha mthupi. Pankhaniyi, chithandizo cha matenda aliwonse chiyenera kugwirizanitsidwa ndi hypoglycemic therapy.

Matenda a shuga ndi mtima

Udindo wa matenda a shuga ndi matenda a ziwalo zamkati pakuwonjezera kufa kwa odwala okalamba amawonekera kwambiri mu mtima wa mtima. Matenda a mtima ndi sitiroko odwala omwe ali ndi matenda ashuga amakula nthawi 6 kuposa magulu ena odwala.

Zomwe zimayambitsa matenda a mtima, monga matenda oopsa, kunenepa kwambiri, komanso kuperewera kwa lipid metabolism mu odwala matenda ashuga ndizofala kwambiri. Matenda a shuga enieni ndiwomwe amachititsa kuti matenda ena a mtima ayambe kudwala (CHD).

Akatswiri ambiri amtima komanso ma endocrinologists amawona matenda ashuga ngati ofanana ndi mtima ischemia. Chifukwa chake, mukamayang'ana odwala omwe ali ndi matenda ashuga, makina owonjezera a maphunziro a mtima ndi zizindikiro zamafuta a metabolism ayenera kuyikidwa, ngakhale pakhale chithunzi cha matenda a mtima.

Zomwe zimayambitsa chitukuko cha matenda a mtima ndi mtima m'matenda a shuga ndi awa:

1. Hypercholesterolemia - kuchuluka kwa cholesterol ndi 1 mmol / l kumawonjezera chiopsezo cha matenda amtima ndi 60%.
2. Lipoprotein yotsika kwambiri m'magazi
3. Hyperglycemia ndi kuchuluka glycosylated hemoglobin.
4. Kuchuluka kwa kuthamanga kwa magazi ndi 10 mm. Hg. Art. zimawonjezera chiopsezo cha matenda a mtima ndi 15%.
5. Kusuta kumawonjezera zotupa za mtima ndi 41% pokhudzana ndi omwe sasuta.

Upangiri wopewa matenda a mtima ndi mtima ndi kuchepetsa shuga m'magazi mpaka 5-7 mmol / l, atatha maola awiri kuti 10. Komanso, hemoglobin ya glycosylated sayenera kupitirira 7%. Izi zitha kuchitika pang'onopang'ono poonetsetsa kuchuluka kwa shuga komanso kugwiritsa ntchito zakudya zomwe zili ndi index ya glycemic yotsika.

Cholinga cha mankhwala ochepetsa shuga ziyenera kuchitidwa poganizira zotsatira zake zoyipa pamtima dongosolo (Glibenclamide, Tolbutamide, Chlorpropamide). Odwala omwe sangathe kulipidwa ndi mapiritsi a shuga amawonetsedwa ndi insulin onse pakuphatikizira mankhwala komanso ngati mankhwala oyenera.

Kuthamanga kwa magazi kuyenera kusungidwa pamlingo wochepera 130/80 mm RT. Art. Zizindikiro zotere zimachepetsa chiopsezo cha myocardial infarction ndi stroke, komanso kufa ndi kulemala kwa odwala.

Cholinga cha mankhwala ochepetsa kupanikizika kwa odwala omwe ali ndi matenda ashuga ayenera kutengera mphamvu yawo pa chakudya ndi mafuta, kuteteza minofu ya impso ndipo osakhudza mawonetsedwe a hypoglycemia. Mwa izi, magulu otsatirawa a mankhwalawa amagwiritsidwa ntchito:

• ACE inhibitors (angiotensin-converting enzyme) amalembedwa mapuloteni mukaonekera mu mkodzo, kugwiritsa ntchito kwawo kumachepetsa chiopsezo cha matenda a shuga 2 (kuwonjezera chidwi cha insulin. Izi zikuphatikiza: Enap, Ramipril, Lisinopril, Captopril.
• Angiotensin receptor blockers 2. Kukhala ndi zomwe gulu lakale la mankhwala, kuteteza malinga a mitsempha ya magazi ndi impso. Awa ndi mankhwalawa Teveten, Aprovel, Cozaar, Lorista, Mikardis, Valsacor, Exforge.
• Ma calcium blockers - Verapamil, Nifidepine, Diltiazem.
• Ma diuretics - Furosemide, Tryphas.
• Imidiazoline zolandilira zimachepetsa ntchito ya mtima wamanjenje ndipo nthawi yomweyo zimawonjezera chidwi cha minyewa kupita ku insulin. Izi zimaphatikizapo Physiotens ndi Albarel.

Nthawi zambiri, kuphatikiza mankhwala ndi mankhwala ochokera m'magulu osiyanasiyana kumagwiritsidwa ntchito.

Pofuna kuthana ndi dyslipidemia, odwala amalangizidwa kuti aziletsa mafuta azinyama muzakudya zawo - nkhumba, mwanawankhosa, offal, mafuta wowawasa wowawasa, kirimu ndi tchizi cha kanyumba, amachepetsa kumwa ndipo nthawi yomweyo idyani masamba atsopano, zipatso zosaphatikizidwa, kuphatikizapo chinangwa, nsomba ndi masamba mafuta muzakudya.

Pofuna kupewa kupitirira kwa matenda ashuga komanso zotupa zam'matumbo, ndikofunikira kusungiratu zizindikirozi (mmol / l): liproproteins yotsika pansipa 2.6, yayitali - kuposa 1.1, triglycerides - osakwana 1.7.

Ngati zakudya zalephera kukwaniritsa zoterezi, ndiye kuti kukonzekera kwa statin kumawerengedwa: Zokor, Krestor, Liprimar.

Kunenepa kwambiri komanso matenda a shuga

Chiyanjano pakati pa matenda amtundu wa 2 komanso kunenepa kwambiri kumalumikizidwa ndi zomwe zimapangitsa kupezeka kwawo komanso kuwonjezereka kwa zizindikiro. Udindo waukulu wobadwa nawo ndi chikhalidwe cha kadyedwe, njira zambiri za chitukuko zimayambitsa kutsimikiza zakuchepa kwa kunenepa kwambiri pochizira matenda ashuga.

Kudzikundikira kwa mafuta kumapita patsogolo ndikukula kwa minofu kukana insulin. Mkulu ukakhala wokwanira kukana, insulin yochulukirapo imapangidwa ndi kapamba, potero kumawonjezera mafuta achilengedwe.

Kuphatikiza pakuchulukitsidwa kwamafuta, kuperewera kwa serotonin kumatha kufalikira. Izi zimapangitsa kuti muzikhala ndi nkhawa nthawi zonse, kukhumudwa, kulakalaka ndi njala. Kulandila kwa chakudya chama carbohydrate kumathandizanso kuti musinthe komanso kuti muchepetse Zizindikiro zopweteka kwakanthawi. Kudya zakudya zonona ndi zotsekemera kumawonjezera ngozi ya matenda a shuga komanso kunenepa kwambiri.

Njira zomwe zimatsogolera pakupititsa patsogolo kagayidwe kazakudya ndi kusadya bwino, kudya mosasamala, kupanikizika ndi kudya pambuyo pake, kusowa tulo komanso kusowa kolimbitsa thupi.

Kuphatikiza pa vuto lodzikongoletsera, kunenepa kumasokoneza kugwira ntchito kwamkati, komwe kumadziwoneka mu:

• Matenda a mtima ndi myocadiopathy.
• Matumbo am'mimba - matenda a gallstone ndi kapamba.
• Kuwonongeka kwamafuta kwa chiwindi.
• Matenda ophatikizika.
• Kusowa kwa msambo kwa akazi.
• Kuchepetsa potency mwa amuna.
• Mkulu matenda oopsa.

Kuopsa kwa zovuta zamankhwala mu kunenepa kwambiri ndi matenda a shuga ndikupanga kudalira komanso zovuta zakulepheretsa zakudya. Mzere woipa umapangidwa: Kulakalaka maswiti - kudya kwambiri - kuchuluka kwa magazi m'magazi - kumasulidwa kwa insulini - kuphatikizidwa kwa chakudya chamagulu m'mafuta omwe ali ndi gawo la insulin - dontho la shuga - kufuna kudya maswiti.

Njira imodzi yothanirana ndi kudalira kwa chakudya cham'mimba ndikutenga chromium picoline kwa masabata 3-4. Kuphatikiza apo, mankhwala ochepetsa shuga amagwiritsidwa ntchito - Metformin, Glucobay. Odwala omwe apanga kwambiri insulin yawo, ngakhale atakhala ndi hyperglycemia yayikulu, samawonetsedwa chifukwa chothana ndi insulin.

Njira yothandiza kwambiri yochepetsera shuga ndi magazi ndichakudya chochepa kwambiri. Zimaphatikizapo zinthu monga: nyama yokonda, nkhuku, mazira, tchizi. Maziko a menyu ayenera kuwiritsa kapena kuwotcha nsomba, nsomba zam'madzi, masamba.

Ndikofunika kwambiri kukonza masaladi atsopano kuchokera ku kabichi, zitsamba, nkhaka, tomato ndi tsabola wokoma kuchokera masamba.

Mafuta chiwindi ndi shuga

Chiwindi ndi kusintha kwa kapangidwe ka magazi - kudzikundikira kwa poizoni wa bakiteriya, mankhwala kapena kagayidwe kachakudya, kamakhudzana ndi kuphatikizidwa kwamafuta m'maselo. Kuchita kotereku kumatha kuchitika panthawi yanjala, masamba okhwima, malabsorption m'matumbo, kuledzera.

Ndi matenda a shuga, mapangidwe owonjezereka a matupi a ketone amakula chifukwa chophwanya kagayidwe kazachilengedwe. Amatha kudzikundikira mu ziwalo za chiwindi. Mafuta ochulukirapo omwe amalowa m'matumbo ndikulowera magazi, kenako kulowa m'chiwindi, amatha kuthana ndi mafuta.

Mwa anthu athanzi, mafuta acids amagwiritsidwa ntchito popanga mphamvu, ndipo mu mtundu wa 2 shuga, insulin, yomwe imapangidwa m'matumbo kwambiri, imalepheretsa njirayi ndikuwonjezera kuchuluka kwa mafuta m'chiwindi.

Ndi kunenepa kwambiri komwe kumayenderana ndi matenda a shuga, mafuta a hepatosis amapezeka nthawi zambiri, ndipo ndi chimodzi mwazizindikiro za dysmetabolic syndrome. Chifukwa cha kuthekera kwa chiwindi kuphatikiza mafuta, chimbudzi ndi momwe mankhwalawo amadzidulira.

Zizindikiro za matenda a hepatosis yamafuta nthawi zambiri sizimawoneka. Kuopsa kwa hypochondrium yoyenera, yowonjezereka chifukwa cha kulimbitsa thupi, kungakhale kosokoneza. Ndi palpation, kupweteka kumatha kuchitika pokhapokha ngati kudzikundikira kwamphamvu kwamankhwala kungayambitse matenda ashuga.

Kuzindikira kumakhazikitsidwa pazizindikiro izi:

1. Ultrasound, yowerengera tomography - mawonekedwe ophatikizidwa, kuwonjezeka kukula.
2. Ntchito ya seramu chiwindi michere imachuluka.
3. Kuchuluka kwa cholesterol ndi triglycerides m'mwazi.

Chithandizo cha hepatosis yamafuta chimachitika ndi zakudya ndi kuphatikizika kwa mankhwala a lipotropic: oatmeal, nsomba, tchizi chanyumba, nsomba zam'nyanja, soya, kefir, yogati, mafuta ozizira osakanizidwa. Zimathandizira kuchotsa mafuta owonjezera ndi mafuta a cholesterol okhala ndi fiber ndi pectin. Chifukwa chake, chakudyacho chikuyenera kukhala masamba ambiri. Ndi chizolowezi chodzimbidwa, ndikofunikira kuwonjezera chinangwa m'mbale.

Mwa mankhwala omwe amagwiritsidwa ntchito hepatoprotectors - Gepabene, Essentiale, Essliver, Glutargin ndi Berlition.

Matenda opatsirana a shuga

Matenda a shuga amapezeka ndi kuchepa kwa mayankho a chitetezo cha mthupi, zomwe zimapangitsa odwala kukhala pachiwopsezo cha mabakiteriya ndi mavairasi, matenda oyamba ndi mafangasi. Matenda oterewa amadziwika ndi pafupipafupi komanso mwamphamvu. Pankhaniyi, matenda amachititsa matenda ashuga.

Pali matenda opatsirana omwe samapezeka mwa anthu opanda zovuta za metabolic - zopweteka zakunja za otitis media, emphysematous variants of cholecystitis, pyelonephritis ndi cystitis, phazi la matenda ashuga.

Odwala omwe ali ndi matenda a shuga amadwala matenda opatsirana nthawi 1.5 nthawi zambiri kuposa ena. Izi zimachitika chifukwa chakuwonongeka kwa chitetezo cha mthupi komanso kwanthawi zonse. Zomwe zimaphatikizidwa ndikuphwanya ntchito ya maselo oyera magazi kuwononga mabakiteriya - kuchepa kwa kayendedwe, phagocytosis, ndi zochitika za opha T.

Zomwe zimachitika m'deralo zimagwirizana ndi kukula kwa mitsempha yowonongeka - yaying'ono ndi macroangiopathy, neuropathy, yomwe imayeretsa kuyeretsa ndi kubwezeretsanso ziwalo zowonongeka kuchokera ku ma virus ndi ma sumu awo.

Kuwopsa kwa matendawa kumachitikanso chifukwa cha kuyipa kwa antimicrobial. Ndi milingo yayitali kwambiri ya lipoprotein, cholesterol ndi mafuta acids, amamangirira kumapuloteni amwazi omwe mankhwalawa amayenera kunyamula. Chifukwa chake, mwa odwala omwe ali ndi matenda ashuga, kuperekera kwa maantibayotiki ku lesion kumachepetsedwa.

Chizindikiro cha chibayo m'magazi a shuga ndi chiopsezo cha bacteremia, chomwe chimayambitsa imfa. Othandizira a causative nthawi zambiri amakhala staphylococci, Klebsiella ndi streptococci. Poyerekeza ndi chibayo, odwala nthawi zambiri amadwala matenda a shuga a ketoacidosis. Mitundu yayikulu, mankhwala a antibacteria ogwiritsa ntchito beta-lactams ndi fluoroquinolones akuwonetsedwa.

Pyelonephritis nthawi zambiri amapezeka mu kuwonongeka kwa impso. Maantibayotiki amaikidwa kokha kudzera m'mitsempha kapena m'mitsempha: Ciprofloxacin, Ceftriaxone, Levofloxacin. Onetsetsani kuti mukugwiritsa ntchito maantibayotiki omwe ali ndi mankhwala antifungal kuti mupewe candidiasis.

Kupezeka pafupipafupi kwa matenda ofewa a minofu ndi phazi la matenda ashuga. Izi ndichifukwa cha zifukwa izi:

1. Kuchepetsa chidwi chowonongeka.
2. Matenda oyamba ndi fungus.
3. Zosokoneza magazi m'miyendo.

Zilonda zikagwidwa ndi matenda, pamatha kukhala njira ziwiri zakupangika kwa matenda: Matenda osapsa (osadulidwa) komanso owopsa, zomwe zimapangitsa kuti azidula mbali yakumanjayo.

Fomu yofatsa imakhalapo ngati chilonda chapamwamba kwambiri ndi zotupa zam'mimba zosakwana 2 cm mulitali; palibe zizindikiro za kuledzera. Mankhwala opangira opaleshoni pachilonda ndi kuikidwa kwa maantibayotiki akuwonetsedwa: Cephalexin, Clindamycin. Kutsegula pakamwa.

Matenda owopsa amawonetsedwa ndi zilonda zam'mimba zowonongeka kwambiri ndi minyewa yozungulira, kuledzera kwathunthu, komanso kuchepa kwa magazi m'dera lomwe lakhudzidwa. Magazi a shuga m'magazi nthawi zambiri amakhala okwera. Kupatula osteomyelitis, kuphatikizidwa kwa minofu ya mafupa kumachitika.

Maantibiotic amaperekedwa kudzera mu mtsempha wa magazi ndi ma intramuscularly: Amoxiclav, Vancomycin, Meronem. Kutalika kwa chithandizo sikuchepera mwezi umodzi. Ndi kusakhazikika kwa njira zosasinthika zamankhwala, kudula pang'ono kapena pang'ono kwa ziwalo zomwe zakhudzidwa.

Mu shuga mellitus, chimodzi mwazofooka ndimatenda a khungu ndi mucous membrane. Odziwika pafupipafupi zotupa za fungal:

• Dera la Inguinal.
• Pindani pansi pa zofunikira za mabere.
• Zowonjezera

Ndi chosakwanira chindapusa cha matenda ashuga, ma candidiasis amatha kupezeka ndi matenda amkamwa mwa mawonekedwe a zolembedwa zoyera, limodzi ndi kuwawa ndi kuwotcha. Ngati afalikira kummero, zimakhala zovuta kumeza. Nthawi zambiri candidiasis amawonetsedwa mwa maliseche.

Candidiasis amathandizidwa makamaka pogwiritsa ntchito mafuta antifungal ndi suppositories mwa akazi. Kugwiritsa ntchito komweko kumaphatikizidwa ndikutenga maphunziro a fluconazole. Ndi kukula kwa kukana ndi izi, amasinthana ndi Itraconazole kapena Ketoconazole.

Kupambana kwa mankhwala opha maantibayotiki kumadalira kuchuluka kwa chiphuphu cha matenda ashuga. Odwala omwe ali ndi matenda opatsirana amtundu wachiwiri wa shuga, insulin imayikidwa mu maphunziro kapena imasungidwira kwa iwo isanathe chithandizo cha matenda a concomitant. Kanemayo munkhaniyi atchulanso za moyo wodwala matenda ashuga.